| NPI | 1366064735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS WINTERS Hrmanager 180-021-0081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2020-05-08 |